Pain Control

There are a host of techniques for phantom limb pain involving any combination of scalp acupuncture, body acupuncture and/or auricular points. The general idea is to resolve the issues within the sensory cortex of the brain to eliminate/lessen the messages from the brain to the non existent limb. Treatment will of course vary slightly from patient to patient based on their underlying symptoms (i.e. their TCM diagnosis) and the limb(s) affected as the anxiety aspect of whatever caused the loss of limb is important and has systemic effects.

Within the Tam Healing System that we largely utilize the most important of all of these points is GV 19 which we use to effect the sensory cortex and GV 20 for the motor cortex. The other points are generally points which resolve qi stagnation and calm the mind - so LI 4, LV 3, PC 6, HT 5, SP 10, Shen Men. Then you can work with needling corresponding points on either the same side arm as the missing leg or on the opposite leg or both. It really is most important to treat the patients underlying pattern so I can be more specific when you have seen the person and have more signs to discuss.

I haven&#39t treated anyone for phantom limb, but I have worked with a dozen or so amputees for other things. Feng Mei actually raised a good point. Something that needs to be clarified is where the pain is coming from. The surgeons I have spoken to and the people with whom I have worked have said more or less the same thing:

1. There is pain that actually comes from the amputation site, but because of the damage to nervous system and the strangeness of the situation for the brain, it feels and seems as if the pain from the amputaion site affects the limb, even though it&#39s not there any more.

2. The missing limb feels as if it&#39s still there, but there is no pain. The person might still feel to be able to grab things with their hand, or curl their toes et c. This is the basic phantom limb phenomenon without the complication of pain.

3. The phantom limb itself is in pain, and this pain might not have anything to do with the amputation site. This is a whole other kettle of fish.

Most people actually fall into one or all of these categories at some stage, and treatment seems to have been gauged in accordance with their experience. So, for example, Feng Mei&#39s suggestion might work well with people in No.1, but less well for people in No.3.

I dug out some lecture notes I stole from a friend and here is what it says:

"For phantom limb syndrome, use biao-li [method]. Look for ahsi points along the yin-yang related channel on the opposite leg, and needle them for 30-40 minutes. Example: right leg amputated, Stomach meridian. Look for ahshi points along whole of Spleen meridian of left leg. Needle at first the most painful point/points."

Since all the meridians are affected, what this basically boils down to is that you have to palpate all six meridians of the other leg looking for ahsi points, whether they be above or below the level of the amputation site on the affected leg. Like I said, I have no direct experience of this treatment, so I have no idea if it works. I do however have experience with the system whence I filched the lecture notes, and as a system, it&#39s quite good. (Unlike my shampoo, I have recommended it to friends.)

Another consideration that I they told me is that the kind of pain in No.3 changes, or can be helped more effectively, if the person has reached the point in their life that they no longer dream of themselves as being having that limb. They appear in their dreams as amputees.

One last thing: many people like those described in No.3 would not necessarily like to loose the sensation or feeling or experience of the phantom limb, if only they could get rid of the pain.

Hi!

I read your folow-up to a friend who lost four fingers of her left hand when she was a kid. She said she&#39d love to be able to bend her fingers again like your lady did with her calf, and that you did was a wonderful gift for your client. She described how for years after her accident, she could feel and bend her fingers quite clearly and distinctly, but for some reason, over time, the sensation, though still strong, became less defined. She said she felt her fingers like frozen Findus fish fingers. I asked if she would like to try acupuncture. She waved her empty hand at me. She said she was flipping me a fish finger.

What was your choice of points based on?